County Employee Benefits Consortium of Ohio

Transcription

1 CEBCO County Employee Benefits Consortium of Ohio l CEBCO was formed by the County Commissioners Association of Ohio (CCAO). l January 1, 2004 was the first effective date of the program in response to concerns over the rising cost of providing health benefits. 1

2 Board of Directors l The Board of Directors is the policy-making arm of CEBCO and they oversee the business and affairs of the consortium. l At least 2/3 are County Commissioners l Up to 1/3 are officers or employees of a member county 2

3 Structure of the Program l CEBCO is incorporated as a not-for-profit entity l CEBCO is a Self-Funded Program l Large, National, Premier Vendor Partners with Dedicated Service Teams 3

4 Vendors Partners names you know and trust ü Anthem Blue Cross Blue Shield - Medical ü CVS/Caremark - Prescription Drug Coverage ü Delta Dental - Dental Coverage ü VSP - Vision Coverage ü ComPsych- EAP ü Anthem Life- Life Insurance ü Aon Hewitt for Actuarial/Consultant Services 4

5 Standard Plan Designs l In order to help manage administrative costs, the goal of the program is to use standard plan designs l Medical-5 standard PPO Plans and 2 HSA Plans l RX-5 standard plans l Dental-3 standard plans l Vision-11 standard plans 5

6 Commitment to Preventive Care l Preventive Care received by a network provider is covered without a copay for the Office Visit under all the CEBCO plans. ~Medical History ~Mammography ~Pelvic Exam ~Immunizations ~PSA Test ~Annual Diabetic Eye Exam ~Annual Vision and Hearing Exam ~ Colonoscopy Most services are intended to be rendered in Conjunction with an office visit 6

7 CEBCO Wellness Program l CEBCO Wellness Coordinator l Administers the Wellness Grant Program l Assists the Designated County Wellness Contacts with design and implementation of County specific initiatives l Analysis of data to formulate each County s specific Wellness needs l Conduct Semi-Annual Meeting between Designated County Wellness Contacts l Encourage and facilitate on-going communication between Designated County Wellness Contacts l Create and distribute Wellness Educational Materials 7

8 CEBCO Wellness Program continued l CEBCO Wellness Grant Program l $250,000 in Grants funded by member s equity l Additional $100,000 from member s equity for counties administrative costs l County s Wellness Contacts l Each member county is requested to designate a Wellness Contact l County Wellness Contact is liaison with CEBCO Wellness Coordinator l County Wellness Contact has knowledge of resources unique to their County. 8

9 Participation Requirements l Each member county is required to fulfill a 3 year commitment and then each renewal is for a subsequent 3 year term. l A county can exit the program prematurely but will be subject to the following, if it chooses to do so: Payment of any outstanding debt (Premium or fees) Payment of an early termination penalty = $2 x # of covered employees x #months left on contract Payment of all run-out claims after termination date No ability to share in any future accumulated surplus 9

10 Underwriting Guidelines l 12 month rates with effective date of 1/1 l 100% credibility at 300 employers l Quoted rates are considered contingent until all of the underwriting data is supplied, including current claims within 4 months of effective date l Run-out claims paid upon termination after 3 year commitment 10

11 Premium Rating Buckets l CEBCO Premium Dollars split in 5 different buckets l Claims-dollars for actual claims costs l Reserves-pays claims upon termination of plan l Pooling-costs for claims in excess of pooling levels and under stop loss amount l Contingency Fund-dollars for costs that exceed expected levels l Administration Expenses-program expense 11

12 Benefits of Self-Funding ü Reduced Administrative cost and stop loss fees ü Spread of Risk over larger number of participants ü No Premium tax ü Lower retention (including margin) than fully insured plans ü Non-Profit nature ü Less Volatility of rates over time 12

13 Benefits of Membership l Counties Have Reaped the Benefits of CEBCO Membership l Member Counties have stabilized their costs by participating in the consortium l l As a result of CEBCO, counties who haven t joined the program have also benefited through investment and shadow pricing by competitors CEBCO has shed light on the under-reserved financial status of some selffunded plans Participating Counties Members strong! Allen - Ashland - Ashtabula - Athens - Butler - Carroll - Champaign - Clark - Clinton Darke - Delaware - Fulton - Geauga - Hardin - Hocking - Logan Madison Marion - Morrow - Preble - Putnam - Ross - Seneca - Union Washington - Williams 13

14 CEBCO FACTS l 26 member counties strong l 9,800 employee lives l 25,000 covered lives l $110,000,000 billed premiums for

15 Historical Renewal Experience County Employee Benefits Consortium of Ohio Rate increase s are before the application of Prescription Drug Rebates 15

16 Run Out Assistance l The CCAO has a loan program to assist counties that wish to move to the CEBCO program with their run out costs l We have the ability to loan money to the county at a very competitive interest rate to assist them in the move to the CEBCO plan 16

17 Why CEBCO? l Rate Stability l Reduced Administrative Costs l Safety in numbers pooling of risk l Economies of Scale l Premier Vendor Partners l Cost Containment and Control l Guaranteed Cost Approach to Renewal Rating l CEBCO Support Staff 17

18 CEBCO County Employee Benefits Consortium of Ohio Tom Strup Interim Managing Director (614) or 18